Pulsatile tinnitus and the vascular tympanic membrane: CT, MR, and angiographic findings.
The radiologic studies of 107 patients with pulsatile tinnitus or a vascular retrotympanic mass were retrospectively reviewed. Of the 100 patients with pulsatile tinnitus, 25 had objective tinnitus. A vascular tympanic membrane was present in 37 cases (35%). Normal vascular variants were present in 23 patients (21%). Twenty-seven patients (25%) had acquired vascular lesions. Temporal bone tumors were found in 33 patients (31%). No abnormality was identified in 21 cases (20%). To ensure optimal radiologic examination, it is imperative to know the nature of the tinnitus (objective vs subjective) and the appearance of the tympanic membrane. All patients with subjective pulsatile tinnitus or a vascular retrotympanic mass should undergo high-resolution computed tomography of the temporal bone as the initial imaging study. Angiography is recommended for patients with objective tinnitus and a normal tympanic membrane. The role of MR imaging, even with the addition of gradient-echo techniques, remains limited and secondary.
Remley
K B
KB
Department of Radiology, Univeristy of Utah Medical Center, Salt Lake City 84132.
Coit
W E
WE
Harnsberger
H R
HR
Smoker
W R
WR
Jacobs
J M
JM
McIff
E B
EB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002648:Child; D004427:Ear Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D004428:Ear Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000175:diagnosis / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014012:Tinnitus / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014432:Tympanic Membrane / Q000098:blood supply* / Q000000981:diagnostic imaging; D014652:Vascular Diseases / Q000000981:diagnostic imaging